HWR- Issue #37

Now a joint publication of the FJMC and MRJ

 Issue #37 -  December 6, 2016

We would like to thank our sponsor RCA, Retirement Corporation of America. They have graciously been our primary sponsor for the last 2 years.


Making your health a priority is our number one goal! We have only so many things we can control in our lives. Health should never be taken for granted and should be your number one priority. This is the reason we started writing this Health Wealth and Retirement (HWR) newsletter

The tips we give are to help understand the value of taking care of yourself and your family and some ideas on how to do it. At the convention in July we will be addressing health in much great detail.  Please visit convention.fjmc.org to learn more about what we have planned at the 2017 FJMC Convention.

This weeks HWR addresses Female Sexual Dysfunction. It is a two part discussion. The first is by Dr. Seth Cohen and Dr Steve Mandel involving Geriatric female sexual dysfunction and the second by Elisabeth Mandel a licensed marriage and family therapist in NY is our featured writer.

Female Sexual Dysfunction – Geriatric

Female sexual dysfunction (FSD) is recognized as a common medical problem in all age groups.  In the assessment of FSD, it is important to determine if the FSD is due to the physiologic effects of a medication, such as an antidepressant or chemotherapeutic agent, or due to a medical condition such as a hormonal or metabolic abnormality. The two most common presenting symptoms for women are low libido and vulvo-vaginal atrophy.

Low libido and desire, clinically referred to as hypoactive sexual desire disorder (HSDD), is defined as a persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty.  Causes of HSDD are often times multifactorial.


Treatment of HSDD is split into two categories, hormonal and non-hormonal.  Systemic testosterone has been shown to improve mood, energy, stimulation, sensation, arousal, and orgasm in women with sexual healthconcerns. Systemic testosterone in the form of transdermal patches, gels and injectables have been used to to treat HSDD in an off-label fashion since it is not FDA approved for applications in women.

A better understanding of the neurobiological basis of sexual desire supports the idea that selective psychoactive agents may be utilized as non-hormonal treatments to restore the balance between excitatory and inhibitory stimuli leading to a normal sexual response cycle. Flibanserin, a 5-HT1A agonist and 5-HT2A antagonists, was approved in the US in August 2015 as the first non-hormonal FDA approved medication to treat HSDD. The efficacy of flibanserin 100 mg once daily at bedtime as a treatment for HSDD is supported by results from three randomized placebo-controlled trials in North American pre-menopausal women with HSDD.

Vulvo-Vaginal Atrophy:

The female vaginal tract relies on estrogen stimulation to maintain normal structure and function. After menopause, estrogen deficiency results in vaginal atrophy causing dyspareunia, vaginal dryness, irritation, and burning. VVA is common; the incidence is estimated to be approximately 60% among menopausal women. Unlike some symptoms of menopause, such as hot flushes that lessen or disappear with time, symptoms like dyspareunia related to VVA usually persist and can even worsen without treatment. Based on the history and physical examination, local estrogen treatment may be safely achieved with vestibular estradiol alone or intra-vaginal estradiol alone or a combination of both.

Ospemifene is a selective estrogen receptor modulator (SERM), which acts similarly to an estrogen on the vaginal epithelium. Ospemifene helps to build vaginal wall thickness helping to reduce the pain associated with dyspareunia. The safety of ospemifene has been proven in two long-term studies that showed oral ospemifene 60 mg was effective for the treatment of VVA in postmenopausal women with dyspareunia.

From the perspective of biology-focused clinicians, identification of the underlying pathophysiology of the sexual dysfunction is essential. Of the many challenges facing healthcare professionals today, the first is to improve the ability to accurately diagnose women with sexual health concerns and the second is to ensure that they receive the best evidence-based available management options. The most logical treatment algorithms consist of starting with the least invasive treatment moving to more invasive strategies after appropriate counseling has ensued.

The first course of treatment for female sexual dysfunction should always be couples therapy in order to determine if the sexual dysfunction is symptomatic of relational dysfunction.  There may be no need to approach female sexual dysfunction physiologically, and the danger of resorting to medicinal care over psychotherapy is that the problem may get worse if the couple continues to avoid resolving the underlying issues.

Oftentimes female sexual dysfunction can be symptomatic of insecurity in the relationship.  In other words, her mind is telling her body to "not let him in."  A couples therapist will be able to assess for history fo sexual trauma or current emotional trauma.  Uncertainty about the relationship may prevent the woman from orgasming because she does not feel physically or emotionally safe with her partner.

A couples therapist guides the partner in supporting the woman in the way she needs.  If the partner frequently displays frustration and helplessness, this may exacerbate the problem by increasing the woman's pressure to perform.  Couples therapy will help partners understand the meaning of the sexual dysfunction to clarify the problem and redefine it as a systemic issue.

In our new format we have formed a great team of Doctors and Psychologists to give you the best possible healthtips in terms you can understand.  Our new team consists of our new Co-Medical Editor - Dr. Steve Mandel Pediatric Neurologist, Dr. Seth Cohen, Dr. Joel Kurtz, Gastroenterologist; Dr. Mitchell Ross, Cardiologist; Dr. Dale Levy, Thoracic Surgeon; Dr. Gary Katz, Psychologist; Dr. Bob Braitman, Pediatrician; Elliot Feldman, CEO low vision occupational Therapy Clinic; and Elisabeth Mandel, Licensed Marriage and Family therapist.  Elisabeth Mandel is a New York Licensed Marriage and Family Therapist and maintains a private practice in Midtown Manhattan where she treats individuals, couples, and families.  Her specialties include: sexual and emotional compatibility, infidelity, dating and breakups.

For questions please email the editors Richard Gray rwgray1@gmail.com, Gary Smith DVM gsmith@fjmc.org, or Dr. Steve Mandel- drmandel1979@aol.com


"Success is not the key to happiness - happiness is the key to success if you love what you are doing you will be successful" - Albert Schweitzer

Are Cash and Traditional Credit Cards Done For?

Five years from now it very well may be that we will only be using our phones to pay all of our bills. Many of us baby boomers do not have the ability to learn the new technologies and keep up with their growth.  Well, maybe we need to make sure that we are learning enough to understand financial literacy and what is happening in our world.  So many things are changing and changing fast. I know this sounds preposterous but lets take a look at why Dr. Steve Sjuggerud from Stansberry investments believes this will happen.  Incidentally, I have read his material for about 5 years now and his predictions are almost always spot on.  This trend is an unstoppable trend that no one is talking about.

Why should I change?  I do not think this will happen?  Why should I pay everything with a mobile phone?  Most of us are asking these questions if not to someone else then we are saying it to ourselves.

If you are questioning this approach think back 25-30  years ago. Almost, everything we bought was paid for by check, or cash,or honesty.   Then credit cards came around and we started using them and now we have the pay by phone.  Most of us are slow to take this method up but millennials are now ensconced in this method of payment.

China is about three years ahead of us.  Almost everyone is paying with their phones.

The benefits of paying by phone-

  1. One swipe over the reader with your phone
  2. No looking for credit cards and fumbling thru pockets and wallet
  3. Much less chance of someone stealing your card and or its number
  4. Much easier and simpler
  5. When you pay by phone no one can see your name or any other personal information

Starbuck’s now has 20% of it’s customers paying by their mobile app.  This is a win-win for everyone.  Less wait time, they give incentives for paying with mobile app and it gives them a chance to advertise to you. In China an ecosystem called We Chat is used for pay be phone. The parent company Tencent is the fastest growing company in the world. There is so much more to this new wave but there is simply to much to discuss in one wealth tip article. I brought this up so that you can do your own research and get on board for mobile apps to pay your bills.  Let me tell you there are pure stock plays so do your research and get in on the bottom floor of this rapidly developing trend.

Steve Sjuggerud gave me the insights and knowledge to write this article. With his always progressive financial thinking it helps to keep myself on the cutting edge of the changes occurring in the world. 

Here's to our Health Wealth and Retirement:

We hope you have enjoyed this wealth tip. It is very valuable and several newsletters, including RetirementMillionaire, use this as one of their tools to building wealth.

We appreciate you giving us feedback so we can continue to bring you amazing tips on health and wealth. If you would like to get in touch with us email either Richard Gray or Gary R. Smith, DVM.

The Wealth Conference at our International Convention in DC in July 2017 (to be immediately followed by the Womens League (WLCJ) Triennial convention will be a wonderful way to keep up with what is the latest in WealthManagement.  Each issue we will try to fill  you in more about this.

We hope that you enjoyed this issue and will consider sharing with other members of your club, family, and friends.  Ask them to opt-in and receive this newsletter.  If you're receiving this from a friend forwarding you the newsletter, you’ll need to ‘opt-in’ to receive this newsletter.  To opt-in, and receive this bi-weekly publication, click on the following link, and provide us with your email address: https://fjmc.org/civicrm/mailing/subscribe?reset=1&gid=1302.

Email sent at approximately 11:30 pm, December 6, 2016

LEGAL DISCLAIMER: This work is based on current events, interviews, corporate press releases, and what we've learned from several mentioned health and wealth newsletters. It is also based on some personal experiences. It may contain errors and you shouldn't make any investment decision based solely on what you read here. It's your money and your responsibility. FJMC is not making specific recomendations of stocks or bonds just possible ideas that might be considered for research and investing purposes. This information is being provided for informational purposes only.

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